NPIMap

Organization Active NPI

Kayoko Obara, DMD PC

  • Dental Clinic/Center
  • Brookline, MA
National Provider Identifier
1477920098
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
18242 Issued in MA
Legal business name
KAYOKO OBARA, DMD PC
Practice address
77 Pond Ave.
#103
Brookline, MA 02445
Phone
(617) 566-1717
Fax
(617) 739-3326
NPI assigned
Aug 31, 2015
Last updated
Aug 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kayoko Obara, D.M.D.NPI 1053570275
Title
Owner
Phone
(617) 566-1717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 18242 MA Primary

Addresses

Primary practice location

77 Pond Ave.
#103
Brookline, MA 02445

Mailing address

77 Pond Ave.
#103
Brookline, MA 02445
Phone (617) 566-1717

National Provider Directory

National Provider Directory

Locations

77 Pond Ave
Ste 103
Brookline, MA 02445
Phone (617) 566-1717

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1477920098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 POND AVE.",
            "address_2": "#103",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "617-566-1717",
            "fax_number": "617-739-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 POND AVE.",
            "address_2": "#103",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "617-566-1717",
            "fax_number": "617-739-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYOKO OBARA, DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "OBARA",
        "authorized_official_first_name": "KAYOKO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-566-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "18242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.